Abscess of liver
Abscess of the liver . Piogenic abscesses after widespread use of antibiotic therapy have become a rare disease. Occur as a result of an ascending biliary infection; Hematogenous spread of infection through the portal venous system or through the hepatic artery in sepsis; Direct spread of infection in inflammatory diseases of the abdominal cavity; Liver injury. In most cases, liver abscesses are a complication of severe, often purulent, cholangitis, which occurs with cholelithiasis or cancer of extrahepatic bile ducts. Other causes are sepsis, pilephlebitis, which can be a complication of destructive appendicitis, colon diverticulitis, ulcerative colitis.
Pyogenic abscesses can be single, but more often there are multiple abscesses. A single abscess is more often located in the right lobe.
Bacterial flora in the abscess is found in about 50% of cases. When sepsis is more often sown golden Staphylococcus aureus, hemolytic streptococcus, with biliary abscesses, an intestinal wand or a mixed flora is more often found. In recent years, much attention has been paid to anaerobic flora, which can be detected only when sowing pus on a special medium.
Symptoms, course. Abscess of the liver is always a secondary disease. On the background of clinical manifestations of the underlying disease, the temperature acquires intermittent or hectic character, chills, sweating, nausea, and appetite decrease. Pain is a late symptom and is more common in single large abscesses. The liver is often enlarged and the tenderness of its edge appears during palpation. Sometimes there is an ichthyosis of the skin and a sclera. In the analysis of blood - high leukocytosis with a shift of the formula to the left, anemia. When sowing blood, the causative agent of the disease is detected in about 30%, more often with abscesses of septic origin. With a review of fluoroscopy of the abdominal cavity, a high standing and limited mobility of the right dome of the diaphragm are detected, possibly a fluid accumulation in the pleural sinus. With gassing flora on the background of the shadow of the liver can determine the level of fluid, sometimes a deformation of the upper contour of the liver. Diagnostics is assisted by ultrasound examination of the liver, computer X-ray tomography, angiography, as well as liver scanning with technetium-99.
Treatment. Antibiotic therapy in accordance with the sensitivity of microflora. To create a larger concentration of antibiotic in the liver, it is possible to insert a catheter into the hepatic artery (by Seldinger) or into the umbilical vein after its isolation and instrumental bougie for dilatation. With single large or several large abscesses, surgical treatment is indicated - opening and draining of the abscess. Access-laparotomy or thoraco-laparotomy. The most sparing and at the same time effective method of treatment (especially with multiple abscesses) is percutaneous drainage of the abscess under the control of a computer tomograph or an ultrasound scanner.
Complications: sepsis, sub-diaphragmatic abscess, breakthrough abscess in the free abdominal or in the pleural cavity, empyema of the pleura, purulent pericarditis.
The forecast is always very serious. When single large abscesses in the case of timely drainage, up to 90% of patients recover. Multiple abscesses and undrained solitary almost always lead to death.
- Surgical diseases
- Abscess
- Abscess appendicular
- Abscesses of the abdominal cavity
- Abscess of the Douglas space
- Intestinal abscess
- Abscess of the lung
- Soft tissue abscess
- Abscesses of soft tissues after injection
- Amoebic liver abscess
- Prostate adenoma
- Actinomycosis
- Aneurysm
- False aneurysm
- True aneurysms
- Aneurysm of the aortic arch
- Aneurysm of descending thoracic aorta
- Dissecting Aneurysm
- Aneurysm of the abdominal aorta
- Aneurysm of peripheral vessels
- Arteriovenous aneurysm
- Aneurimas of the heart
- Appendicitis acute
- Perforation of the appendage
- Appendicular infiltration
- Pielephlebitis
- Atheroma
- Bronchoectasis
- Varicose veins
- Varicose veins of the spermatic cord
- Dropsy of testis and spermatic cord
- Rectal prolapse
- Gangrene gas
- Gangrene lung
- Hemorrhoids
- Hydradenite
- Gynecomastia
- Hernia
- Internal hernias
- Hernias of the esophagus
- External hernias
- Herniated hernias
- Herniated hernia
- Hernia of the white line
- Hernia postoperative ventral
- Herniated hernia
- Rare hernias
- Pincushion
- Phlegmon hernial sac
- False infringement of a hernia
- Hernias with inflammation
- Dumping syndrome
- Diverticulum
- Esophagus diverticulum
- Cervical diverticulum
- Bifurcation diverticulum
- Epiphrenial diverticulum
- Epiphrenial diverticulum
- Diverticulum of the stomach
- Diverticulum of the duodenum
- Meckel's diverticulum
- Jaundice mechanical
- Bile duct stones
- Ventilated stone of choledoch
- Papillotenosis
- Stricture of bile ducts
- Cancer of the head of the pancreas
- Cholelithiasis
- Urinary retention acute
- Zollinger-Ellison syndrome
- Foreign bodies of bronchi
- Foreign bodies of the stomach
- Foreign bodies of the esophagus
- Foreign bodies of soft tissues
- Carbuncle
- Brushes and fistulas of the neck are lateral
- Cysts and fistulas of the neck median
- Colitis ulcerative ulcerative
- Coccygeal epithelial passage
- Cryptorchidism
- Bleeding
- Bleeding internal
- Bleeding gastrointestinal
- Varicose veins
- The Mallory-Weiss Syndrome
- Bleeding into the abdominal cavity
- Bleeding pulmonary
- Bleeding external
- Parenchymal hemorrhage
- Crohn's disease
- Lymphadenitis
- Lymphangitis
- Mastitis
- Putrefactive mastitis
- Acute non-lactational mastitis
- Chronic mastitis
- Megacolon
- Mediastinitis
- Intestinal obstruction
- Paralytic intestinal obstruction
- Mechanical intestinal obstruction
- X-ray diagnostics
- Specific types of intestinal obstruction
- Ingrown throat
- Frostbite
- Local cooling
- Burn
- Occlusion of the main arteries
- Acute occlusion of the vessels of the extremities
- Acute occlusion of mesenteric vessels
- Chronic occlusions of arterial vessels
- Obtiterating atherosclerosis
- Aortic ileal type
- Hips and popliteal type
- Peripheral type
- Occlusion of aortic arch branches
- Occlusion of carotid arteries
- Occlusion of the subclavian artery
- Takayasu's syndrome (absence of pulse)
- Chronic occlusion of mesenteric vessels (abdominal toad)
- Stenosis of the renal arteries
- Obliterating thrombangitis
- Raynaud's disease
- Orcoepididymitis
- Acute abdomen
- Acute pancreatitis
- Chronic pancreatitis
- Acute cholecystitis
- Panaritium
- Panaritium cutaneous
- Paronichy
- Panaritium subungual
- Panaritium tendinous
- Panaritium articular
- Panaritium bone
- Penetrating ulcer of the stomach and duodenum
- Peritonitis
- Peritonitis chronic
- Piopevneumotorax
- Pneumothorax spontaneous
- Postcholecystectomy syndrome
- Perforated ulcer
- Covered perforation
- Bedsore
- Prostatitis
- Wounds
- Fistulas of the rectum
- Stenosis of the outlet stomach
- Fracture of anus
- Urethritis
- Phimosis, paraphimosis
- Phlebothrombosis
- Occlusion of subclavian vein
- Phlegmon
- Furuncle
- Cholangitis
- Electric trauma
- Empyema of the pleura
- Congenital intestinal obstruction
- Atresia of the anus
- Congenital cholangiopathy of newborns
- Pylorostenosis
- Embryonic hernia (hernia of umbilical cord)
- Exstrophy of the bladder
- Dropsy of shells of testis and spermatic cord
- Surgical diseases of the chest
- Congenital diaphragmatic hernia
- Congenital cysts of the lungs
- Pneumothorax
- Tracheophishoprine fistula
- Mastitis of newborns
- Acute hematogenous osteomyelitis
- Peritonitis in newborns
- Acute paraproctitis
- Necrotic phlegmon of newborns
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